HESI PHARMACOLOGY STUDY REVIEW

HESI PHARMACOLOGY STUDY REVIEW Type of Insulin Generic Name Brand Name Works Within Works Best or "Peak" at Lasts Rapid-Acting insulin lispro (human) Humalog 15 min 30 to 90 min 3 to 4 hrs insulin aspart NovoLog insulin glusiline Apidra Short-Acting insulin injection Humulin R 30 min 1 to 3 hrs 6 to 8 hrs (regular) Novolin R Velosulin Human BR Regular Iletin II Intermediate-Acting isophane insulin suspension (NPH) Humulin N 2 hrs 4 to 12 hrs 24 hrs Lente Novolin N NPH-N Long-Acting insulin glargine Lantus 2 hrs no peak up to 24 hrs insulin detemir ultralente Levemir NPH/Regular Mixtures insulin isophane suspension Humulin 70/30 30 min 2 to 12 hrs 18 to 24 hrs regular insulin Novolin 70/30 insulin lispro protamine Humalog 15 to 30 min 2 to 12 hrs 18 to 24 hrs **ONLY REGULAR INSULIN MAY BE ADMINISTERED INTRAVENOUSLY!!  Gently rotate the vial between palms to disperse the medication particles before drawing up insulin  Always draw up clear (regular) before cloudy (intermediate and long acting); but never mix Lantus***  Sliding Scales  ↑ insulin may be required during active infections, stress, 2nd and 3rd trimesters whereas ↓ insulin may be required in response to the patient’s exercise and the 1st trimester of pregnancy  Rapid acting (Novolog) and short acting (Regular) insulins are usually given per the Dr’s SS orders  Common S/E: lipodystrophy (why we rotate injection sites) and hypoglycemia (can also result when giving insulin in an infrequently used site)  Hyperglycemia  Dry flushed skin  Kussmaul’s respirations (blowing off CO2)  Anorexia, N/V (trying to get sugar out)  Abdominal pain  CNS depression  Fruity breath odor  Eventual coma  Hypoglycemia  Tachycardia and palpitations  Diaphoresis with pale, clammy skin  Tremors, hunger (need to get sugar in)  Headache and dizziness  Anxiety and irritability (poor judgment)  Confusion  Seizures and coma